Friday, October 18, 2013

Should the Administration Shut the Obamacare Computer System Down? That Depends Upon What's Going On Behind the Curtain

My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which
the administration has handled the rollout. If they had developed the
computer system in a transparent way, the marketplace would have told
them long ago this would not work.

No one outside the
inner circle at the Department of Health and Human Services has any idea
what's really going on behind the Wizard's curtain. Hasn't for months.
Doesn't now.So any technical advice any of us could give would be, to say the least, uninformed.

If
I were on the inside, and it were up to me, the first thing I would do
is bring in a group of heavyweight information technology experts to
tell me just what was really going on. The administration cannot trust
the people who have been working on this because they told them to
launch this mess on October 1 and almost three weeks in there has been
no improvement on the website or in the backroom––they no longer have credibility.

I would ask those experts to very quickly answer three questions:

Can this thing be fixed on the fly––as the administration appears to be trying to do?

If
it can't be fixed on the fly––and three weeks into this that sure looks
doubtful––then can it be taken down for one or two months with a high
degree of confidence it can be brought back up in time to enroll people
sooner rather than later?

If the first two options are not
possible, just how long will the computer system have to be shutdown
before Obamacare can be launched in a way that there can be confidence
it will work smoothly?

Then I would take their advice.

Right
now the Obama administration appears to only be looking at this
through a political lens: How do they minimize the political fallout?

There are two things wrong with that perspective.

First,
the politics of this can't get any worse. This is now a political joke.
Republicans can make lots of snarky comments about Obamacare and they
won't be able to do more damage to Obamacare than the administration is
doing to itself. Any Republican reaction to taking the system down won't
last more than a couple of news cycles. More, the President would never
lose politically by making a decision about every American already
knows he has to make.

Second,
the Obama administration, by keeping this computer system up and so far
not being able to fix it, is not only wasting people's time they are
on their way to destroying Obamacare.

As I have
repeatedly said on this blog, the real longer-term threat Obamacare
faces is that not nearly enough healthy people will sign-up for coverage
in order for the program to be able to pay the medical costs for the
sick people who enroll.

Left as is, I have to believe that the only people willing to put up with the repeated attempts
and frustration with the Obamacare website and call centers are people
so sick and in need of health insurance they have no alternative.

The greatest threat to Obamacare right now is a computer system the Obama administration
continues to defend. And maybe their inability to understand how much
damage they are themselves doing to the President's signature domestic
accomplishment.

When these computer problems are finally fixed, then we can move onto the main event: Can Obamacare work?

Washington Post's Wonkblog "Pundit of the Year"

Bob Laszewski was named the Washington Post's Wonkblog "Pundit of the Year" for 2013 for "one of the most accurate and public accounts" detailing the first few months of the Obamacare rollout.

"Top 5 Speaker on Health Care"

Bob Laszewski has been named a "Top 5 Speaker" on health care in a survey involving 13,000 business leaders, educators, association members, and others.

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The purpose of thishealth care blogis to provide an ongoing review ofhealth care policy activity in Washington, DC and the marketplace.

Health Policy and Strategy Associates, LLC (HPSA) is a Washington, DC based firm that specializes in keeping its clients abreast of the health policydebate in the nation's capital as well as developments inthe health care marketplace.

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Robert Laszewski, Washington, DC

Robert Laszewski is president of Health Policy and Strategy Associates, LLC (HPSA), a policy and marketplace consulting firm specializing in assisting its clients through the significant health policy and market change afoot.
Before forming HPSA in 1992, Mr. Laszewski was chief operating officer for a health and group benefits insurer.
The majority of Mr. Laszewski’s time is spent being directly involved in the marketplace as it comes to grips with the health care cost and quality challenge.